Sample HREC Application: NURBN3022 - Nasogastric Tube Placement Study

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Homework Assignment
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This assignment is a sample Human Research Ethics Committee (HREC) application, likely for a nursing course (NURBN3022), focusing on a research project exploring nurses' views on the effectiveness of the pH method for confirming the correct placement of nasogastric tubes in adult patients within a critical care setting. The application details the project's title, researchers (including the principal researcher and student researchers), and a lay description of the research aims. It outlines the research aims, questions, and significance, emphasizing the importance of accurate nasogastric tube placement to prevent complications. The methodology section describes a qualitative research design using semi-structured interviews to gather data from nurses. It also details the recruitment strategy, participant details, and data analysis methods, including thematic analysis. The application references relevant literature and adheres to ethical guidelines for research involving human subjects. The project seeks to understand nurses' perceptions of the pH method's safety, effectiveness, and potential errors, aiming to identify strategies to mitigate these errors and improve patient care. The document also includes details about the assessment task, marking criteria and the context of the assignment.
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Sample Application for
HREC Approval
(NURBN3022)
Total word limit for this assessment item is 2000 words
1. PROJECT DETAILS
Project title:
What type of project is this? (Tick as many as apply)
Masters project Clinical Trial Postgraduate Diploma
Undergraduate Student Research Project Honours
PhD Staff Research Project Other
Through which School/Section is the research to be conducted?
2. RESEARCHERS
Principal Researcher (STAFF MEMBER ONLY)
Title & Name: Dr Joanne Porter
Position: Senior Lecturer
School/Section: School of Nursing and Healthcare Professions
Phone number: 51 236996
Email address: joanne.porter@federation.edu.au
Please list academic qualifications: PhD, MN, GradDipCC, GradDipHSM, GradCertHeD,
BN, RN
Describe what this researcher will do in
the context of this project:
The lead researcher will be an expert guide though all
aspects of the project.
Include a brief summary of relevant
experience for this project:
Supervision of higher degree students, multiple
publications to peer reviewed journals and successful
competitive grants applications.
Student/Other Researcher/s
Title & Name:
Position:
School/Section:
Phone number:
Email address:
Student ID number:
Please list academic qualifications:
Describe what this researcher will do in
the context of this project:
Include a brief summary of relevant
experience for this project:
1
To explore nurses' views on the effectiveness of PH method for confirming the correctness of placement of
nasogastric tube across adults patients in the critical care department.
To explore nurses' views on the effectiveness of PH method for confirming the correctness of placement of nasogastric tube across adult patients in the critical care department
Using a semi structured interview, the opinions of nurses
working in the critical care department of a healthcare
organization, on the effectiveness of using the PH method in
confirming how correct is the placement of nasogastric tube
in critical adult patients, will be explored and evaluated.
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Sample Application for
HREC Approval
(NURBN3022)
3. LAY DESCRIPTION
Provide a brief outline of the project describing in everyday, jargon-free language the key aspects of
the research (e.g., who will be participating, what information will be collected and by what means,
what participants will be required to do, etc.) and the key research aims. (300 words max.)
4. RESEARCH AIMS & SIGNIFICANCE
State the aims, key research questions, and significance of the project. Also provide a brief
description of the relevance of your proposed project to current research, supported by the literature.
(500 words max.)
2
The primary objective of this research is to explore how effective is the PH method in understanding whether
the nasogastric tube has been correctly placed within adult patients who are in a critical health condition.
Considering the same, participants comprising of healthcare workers like nurses will be of most relevance.
Thus, as per the identified objective, the participants for this research project will comprise of registered
nurses, working in the critical care department of a healthcare organizations and delegated for the purpose of
providing clinical care to adult patients. Nurses working in the critical care department will be chosen as the
participants due to their role of direct involvement with adult patients in a critical condition (Etikan, Musa &
Alkassim, (2016).
One of the key aims of this research is to explore the effectiveness of the PH method in understanding how
correctly has the nasogastric tube been placed within critical care adult patients. It is known that a nasogastric
tube is used to administer medication and nutrients in critical care patients who lack the ability to orally ingest
food. Thus, the information to be collected from the participating nurses will be centered around their opinions
and experience regarding how effective is the PH method in confirming that the nasogatric tube has been
placed correctly and is optimally providing nutrients to adult patients admitted in the critical care department
(Chavda et al., 2017).
Considering that the information provided by participating nurses will be based around nursing experiences
while working with critical care patients, the information will be subjective and thus collected using qualitative
means. Thus, considering the same, semi-structured interviews, using questionnaire developed from a reliable,
valid and scholarly academic source will be used for collecting information on PH method effectiveness in
verifying nasogastric tube placement (Peters & Halcomb, 2015). Thus, after providing consent and the option
for voluntary participation, participants, that is, nurses, will be required to attend face-to-face interviews with the
researcher and provide their views on effectiveness of the PH method.
References:
Chavda, V., Alhammali, T., Farrant, J., Naidu, L., & El-Rabaa, S. (2017). Nasogastric tube knotting: a rare and
potentially overlooked complication among healthcare professionals. Case Reports, 2017, bcr-2017.
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive
sampling. American journal of theoretical and applied statistics, 5(1), 1-4.
Peters, K., & Halcomb, E. (2015). Interviews in qualitative research. Nurse Researcher (2014+), 22(4), 6.
Aim: To explore nurses' views on the effectiveness of PH method for confirming the correctness of placement
of nasogastric tube across adults patients in the critical care department.
Research Objectives:
1. To explore nurses’ views on the perceived simplicity, safety and effectiveness of the PH method for
confirming the correctness of placement of nasogastric tube across adults patients in the critical care
department.
2. To explore nurses’ views on sources and likelihood of errors associated with the PH method during its
usage in confirming the correctness of placement of nasogastric tube across adults patients in the critical care
department.
3. To explore nurses’ views on possible strategies which can be implemented to mitigate the errors associated
with the PH method during its usage in confirming the correctness of placement of nasogastric tube across
adults patients in the critical care department.
Research questions:
1. What are nurses’ perceptions on the simplicity, safety and effectiveness of the PH method for confirming the
correctness of placement of nasogastric tube across adults patients in the critical care department?
2. What are nurses’ views on sources and likelihood of errors associated with the PH method during its usage
in confirming the correctness of placement of nasogastric tube across adults patients in the critical care
department?
3. What are nurses’ views on possible strategies which can be implemented to mitigate the errors associated
with the PH method during its usage in confirming the correctness of placement of nasogastric tube across
adults patients in the critical care department?
According to Nordin et al., (2015), nastrogastric tubes, via their insertion through the nostrils and passage to
the stomach, are beneficial in delivering the nutrients, medications, fluids essential for patient recovery as well
as extracting aspirates and thus forms the crux of ensuring positive health outcomes within the critical adult
patient. However, as per Nascimento et al., (2018), incorrect placement may adversely impact the survival of
the patient through complications like: unwanted entry of tube in the lungs and airways causing respiratory
irritation, coiling of the tube in the patient’s throat, esophageal perforation, sinusitis, retropharyngeal abscess,
perforation of the brain, parotitis, reflux of stomach components to the esophagus and ultimately death. Thus,
the need for correct evaluation of tube placement for prevention of complications and ensuring quick recovery,
Document Page
Sample Application for
HREC Approval
(NURBN3022)
5. RESEARCH METHODOLOGY
Provide an outline of the proposed method, including details of data collection techniques, tasks
participants will be asked to do, the estimated time commitment involved, and how data will be
analysed. (500 words max).
6. RECRUITMENT OF PARTICIPANTS
Participant Details
Describe your proposed recruitment strategy to source target participants. Provide the number and
age range, giving a justification of your proposed sample size. (100 words)
Target participants
Who are the target participants? (Tick as many as applicable)
Students or staff of this University
Adults (over the age of 18 years and competent to give consent)
Children/legal minors (under the age of 18 years, with parental consent)*
Elderly individuals
Individuals from non–English-speaking backgrounds
Pensioners or welfare recipients
3
For optimal collection and analysis of data relevant to the identified project title, a qualitative research
design will be implemented. A qualitative research design, as compared to a quantitative one, allows for
in-depth exploration of subjective data in terms of opinions, views and experiences of participants. Since the
research is based on exploring the opinions and experiences of nurses pertaining to effectiveness of the PH
method (Noble & Smith, 2015).
In alignment of the same, data collection will be performed using qualitative methods like an interview. An
interview comprises of participations engaging in a one-to-one conversation with the researcher for the
purpose of sharing their views on the chosen research topic. Considering that this research focuses on the
opinions of nurses on effectiveness of the PH method, an interview will be the most relevant method for
data collection (Galvin, 2015). Thus, a semi structured interview will be used which will further be developed
using a valid questions prevalent in a peer-reviewed, scholarly study to prevent any compromises on
evidence-based validity and reliability of the results obtained in this research (Brinkmann & Kvale, 2015).
To ensure the same, the interview questions will be based upon the those used in the research by Borsci et
al., (2017), which explored the usability of the PH method by interviewing health professionals on its
perceived simplicity, safety, likelihood and causes of errors and potential mitigations.
Firstly, the researcher will obtain permission from the management of the relevant healthcare organization
whose nurses will be recruited as participants for the research. The participating nurses will then be
required to provide their consent on voluntary participation without coercion and will also be assured that
their lack of involvement will not hinder their professional careers. Subsequently, as per the above, the
participating nurses will then be individually interviewed by the researcher where they will provide their
opinions on how safe and convenient is the PH method, how likely and what factors can contribute to errors
in its estimation of nasogastric placement confirmation and what methods can be considered to mitigate
these issues respectively.
An optimum interview requires the researcher to spend considerable time on developing a rapport with the
participants to ensure correctness and comprehensiveness of responses (King, Horrocks & Brooks, 2018).
Thus it is estimated that the researcher may need to commit an estimated time of approximately 20 minutes
for interviewing each participant. After collecting the relevant responses from all the participants, narrative
synthesis in the form of thematic analysis will be used to analyze and evaluate the same. Since it is difficult
to quantify the subjective data obtained in qualitative studies, thematic analysis is the most appropriate form
of analysis since it will allow the researcher to conveniently categorize information into specific groups or
themes (Braun et al., 2019). Thus themes regarding usability, trust, acceptance and effectiveness across
nurses regarding the PH test will be derived based on the nature of responses obtained from the interview
(Borsci et al., 2017).
References:
Borsci, S., Buckle, P., Huddy, J., Alaestante, Z., Ni, Z., & Hanna, G. B. (2017). Usability study of pH strips
for nasogastric tube placement. PloS one, 12(11), e0189013.
Braun, V., Clarke, V., Hayfield, N., & Terry, G. (2019). Thematic analysis. Handbook of Research Methods
in Health Social Sciences, 843-860.
Brinkmann, S., & Kvale, S. (2015). InterViews: Learning the craft of qualitative research interviewing (Vol.
3). Thousand Oaks, CA: Sage.
Galvin, R. (2015). How many interviews are enough? Do qualitative interviews in building energy
consumption research produce reliable knowledge?. Journal of Building Engineering, 1, 2-12.
King, N., Horrocks, C., & Brooks, J. (2018). Interviews in qualitative research. SAGE Publications Limited.
Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Evidence-based
nursing, 18(2), 34-35.
A random sampling strategy will be used where nurses for participating in the interview were randomly
selected using computer generated numbers. A random sampling strategy will be used to ensure prevention
of any bias by the researcher during participant selection. The participants who will be randomly selected
will comprise of the registered nurses working in the critical care department due to their experience, clinical
competency and direct involvement with critically ill patients (Emerson, 2015). Since there is no rule of
thumb to use an exact number for sample size, Slovin’s formula will be used to determine the sample size
as per the formula n = N / (1+Ne2), where ‘n’ is the sample size, ‘N’ is the population size and ‘e’ is the
margin of error. Since nurses with specific qualifications will be recruited, there is no specific age range of
the participants. However, it will be ensured that participants above the age of 18 will be recruited and as
per their competency to provide consent for the study (Suprayitno, Saraswati & Fajrinia, 2017).
References:
Emerson, R. W. (2015). Convenience sampling, random sampling, and snowball sampling: How does
sampling affect the validity of research?. Journal of Visual Impairment & Blindness, 109(2), 164-168.
Suprayitno, H., Saraswati, N., & Fajrinia, C. P. (2017). Developing a method for measuring the quality of a
sample based trip length distribution for urban trip. Rekayasa Teknik Sipil, 3(3/REKAT/16).
Document Page
Sample Application for
HREC Approval
(NURBN3022)
Intellectually or mentally impaired individuals unable/with compromised capacity to provide
consent
Physically disabled individuals
Patients or clients
Prisoners, parolees, or wards of the state
Individuals highly dependent on medical care with a compromised capacity to give consent
Aboriginal and/or Torres Strait Island communities
Women who are pregnant and the human foetus
People who may be involved in illegal activities
*Parental consent may not be required in some instances - refer National Statement, 4.2.8 & 4.2.9
7. RISK MANAGEMENT
This section raises the issue of your duty of care toward research participants. To what risks are
participants subjected? What will you do should an emergency occur, or should a participant become
upset or distressed? What is your risk management strategy?
Refer National Statement: Section 2.1 Risk and Benefit
Research Activities
Which of the following activities will the research involve? (Tick as many as apply)
Use of a questionnaire (attach copy)
Interviews (attach interview questions)
Observation of participants without their knowledge
Participant observation
Audio- or video-taping of interviewees or events
Access to personal and/or confidential data (including student, patient or client data) without
participants’ specific consent
Administration of any stimuli, tasks, investigations or procedures which may be experienced
by participants as physically or mentally painful, stressful or unpleasant during or after the
research process
Performance of any acts which may diminish the self-esteem of participants or cause them to
experience embarrassment, regret or depression
Use of non-treatment of placebo control conditions
Collection of body tissues or fluid samples
4



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Sample Application for
HREC Approval
(NURBN3022)
Identify as far as possible all potential risks to participants (e.g., physical, psychological, social, legal,
economic) associated with the proposed research. Explain what risk management procedures will
be put in place, along with contact details of an appropriately qualified organisation for participant
reference in case of distress, eg: Lifeline (200 words)
8. CONSENT
Obtaining and Documenting Consent
How will informed consent be obtained/recorded?
Signed consent form
Recorded verbal consent
Implied by return of survey
Other (Please specify):
9. INFORMATION PROTECTION (DATA STORAGE & SECURITY)
Confidentiality
Tick which method will be used to guarantee confidentiality/anonymity?
Non-identifiable (anonymous) data, which have never been labelled with individual
identifiers or from which identifiers have been permanently removed, and by means of
which no specific individual can be identified.
Re-identifiable data, from which identifiers have been removed and replaced by a code,
but it remains possible to re-identify a specific individual by, for example, using the code or
linking different data sets.
Individually identifiable data, where the identity of a specific individual can reasonably be
ascertained. Examples of identifiers include the individual’s name, image, and date of birth
or address.
Security and Storage
Does the Principal Researcher accept responsibility for the security of the data
collected?
Yes
Who will have access to data?
Access by named researchers only Access by other(s) than named researcher(s)
5
Since the study will comprise of merely interviewing participating based on their experiences regarding the
effectiveness of the PH method without any form of simulation or practical demonstration, there is no risk of
acquiring physical harm during the process of data collection. Further, participants will also not be at risk of
legal and economic damages since the prior consent will be obtained by the researcher and the study will also
be performed at the expenses of the researcher (Roberts, 2015). However, it is worthwhile to remember that a
large section of data for this research will be based upon experiences reflected and recalled upon by
participants, may subject the participant to recall upsetting experiences which may further cause psychological
distress (Delgado et al., 2017). Thus, is it likely that interviewing the participating nurses regarding their
usage, safety and efficacy of the PH method in determining correct placement of nasogastric tube may cause
distress by recalling upsetting details of experiences related to any patient (Van der Heijden et al., 2017).
To prevent or mitigate such risks, the emergency department as well as management of the concerned
healthcare organization will be alerted by the researcher immediately (Roberts, 2015). Additionally, the
concerned individual will be taken to the nearest qualified mental healthcare organization within the locality,
the contact details of which have been enlisted below:
Name of the service provided: Australian Mental Health Services
Address: 210 Drummond St, South Ballarat VIC 3350, Australia
Phone: +61 3 4343 1333
Working hours: 9:00AM to 5:00PM
Website: http://austmhs.com.au/
References:
Delgado, C., Upton, D., Ranse, K., Furness, T., & Foster, K. (2017). Nurses’ resilience and the emotional
labour of nursing work: An integrative review of empirical literature. International Journal of Nursing Studies,
70, 71-88.
Roberts, L. D. (2015). Ethical issues in conducting qualitative research in online communities. Qualitative
Research in Psychology, 12(3), 314-325.
Van der Heijden, B. I., Mulder, R. H., König, C., & Anselmann, V. (2017). Toward a mediation model for
nurses’ well-being and psychological distress effects of quality of leadership and social support at work.
Medicine, 96(15).




Document Page
Sample Application for
HREC Approval
(NURBN3022)
Which of the following methods will be used to ensure data security?
Data will be kept in locked filing cabinets
Data and identifiers will be kept in separate, locked filing cabinets
Access to computer files will be available by password only
Other (please describe)
10. RESEARCH TOOLS
Please check that the following documents are included in your application by writing in the box
below (300 words)
Are the following research tools are included in this
application?
Yes No N/A
Questionnaire Draft
Interview Questions Draft
Other
6





A questionnaire has been not been added since this research is not quantitative and thus, will not require any
survey. Since the primary data collection to be used for this project is an interview, the questions for the
interview for research have been attached in the application. To ensure research validity, the interview
questions to be used for obtaining information on nurses’ views have been developed from a reliable, valid
and peer-reviewed scholarly source. Thus the research by Borsci et al., (2017), will be referred to for the
interview questions since it is based on exploring the usability of the PH method by interviewing health
professionals on the simplicity and safety of its methods, the likelihood of occurrence of errors and their
possible causes and strategies which can be used for mitigation of the same. For improved understanding, the
following are the questions used in the study by Borsci et al., (2017), which will be used for interviewing the
participants recruited for this research:
1. Is the use pH strips perceived as simple and safe by clinicians?
2. What is the likelihood of misreading the pH paper that could affect clinicians’ decision making?
3. What are the causes of errors?
4. What are the potential mitigation strategies?
Additionally to ensure the prevention and management of any potential psychological risks, as discussed
previously, the details of the nearest mental healthcare organization and support service have also been
attached in the application to ensure timely provision of help to participants in distress. Additionally,
information regarding calculations pertaining to sample size determination have also been included within this
application, to its relevance in research.
References:
Borsci, S., Buckle, P., Huddy, J., Alaestante, Z., Ni, Z., & Hanna, G. B. (2017). Usability study of pH strips for
nasogastric tube placement. PloS one, 12(11), e0189013.
Document Page
Sample Application for
HREC Approval
(NURBN3022)
11. DECLARATIONS
Researcher Declarations:
The information contained herein is, to the best of my knowledge and belief, accurate. I have read
the University’s current human ethics guidelines, and accept responsibility for the conduct of the
procedures set out in the attached application in accordance with the guidelines. I and my co-
researchers have the appropriate qualifications, experience and facilities to conduct the research set
out in the attached application and to deal with any emergencies and contingencies related to the
research that may arise.
Principal Researcher
DR JOANNE PORTER
(Print name in block letters)
Date: …..../…...../….....
Other Researcher
………………………………………………
(Print name in block letters)
Date: …..../…...../….....
Other Researcher
…………………………………………………
(Print name in block letters)
Date: …..../…...../….....
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